POS1503-HPR THE VALUE OF REMOTE CONSULTATIONS WITH A PHYSIOTHERAPIST, SPECIALISED IN AXIAL SPONDYLOARTHRITIS DURING THE COVID 19 PANDEMIC: EVALUATION OF A MEMBER-SUPPORT PROJECT WITH THE NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY.
Authors: E. Clarke, J. Hamilton, S. Dickinson
Journal: Annals of the Rheumatic Diseases (2022)

Background COVID-19 caused significant disruption to Axial Spondyloarthritis (AxSpA) services during the intial 2020 lockdown 1 . In response, The National Axial Spondyloarthritis Society (NASS) piloted provision of remote consultations with a physiotherapist specialised in the management of AxSpA to their members in urgent need. This project was funded by the UK National Lottery Fund Objectives To provide a total of 130 hrs of remote consultation to members of NASS, unable to access specialist care and in need of self-management advice for their condition Methods Remote consultations were offered to NASS members from Sept 2020 to Feb 2021. The preferred format being 1hr assessment and 2 x 30 min at 1 and 3 weeks from assessment. Participants consented to video consultations via Zoom and the inclusion of anonymised outcomes and comments in the project evaluation. Patient Reported Outcomes (BASDAI and BASFI) were collected immediately prior to assessment, at final consultation and in April 2021, between 8- 16 weeks from final consult Content was individually tailored, centring on self-management (pacing, sleep management), education (AxSpA pathology, medication) and individualised exercise plans. Exercise plans were formulated through “Rehab My Patient” software, including links to YouTube video references and daily exercise log sheets. Results 67 members received online consultations, 63 receiving the full 3 sessions. Missed appointment rate = 2.5% Participants represented a wide geographical area across England and a spread in time since diagnosis. Patient Reported Outcomes Measures (PROMs) on assessment: ● Mean BASDAI score (n=55) on assessment = 5.8 ● Mean BASFI score on assessment (n=56) = 5.5 24 participants returned PROMS at final consultation, 10 at longer follow-up (8-16 weeks). Results for complete data set (n=10): Table 1. PROMS Assessment Final consultation Follow-up Mean BASDAI 5.0 4.3 4.0 Mean BASFI 5.1 4.0 4.1 Satisfaction: 60 members completed an online feedback survey provided by NASS: 9 Feedback to questions were asked, with a satisfaction scale of 1-5 (ascending positivity) 99.6% of all scores were 3 or above. Example responses: ● How would you rate the overall experience: 92% = 5, 100% = 3-5 ● To what extent do you feel more confident to manage your condition: 40% = 5, 100% = 3-5 ● How useful was it to be in direct contact with a Physiotherapist: 93% = 5, 100% = 3-5 46 members chose to leave additional, overwhelmingly positive comments, with 2 obvious themes arising: 1)The value of the experience and knowledge of the therapist . “was great to have the guidance and support of a professional who knows what they are talking about when it comes to AxSpA” 2)The value of education in condition management “set me back on track”, ”very helpful for my mental strength in dealing with this enduring disease”, “I learned so much about my AS and ways to keep mobile” Conclusion A set of 1-3 sessions per person achieved desirable patient reported outcomes with modest and enduring improvements seen in disease activity and function. This pilot project enabled those living with Axial SpA across England access to a Physiotherapist highly experienced in treatment of their condition. The majority of participants reported having no previous experience of seeing a therapist with specialised knowledge of their condition. The knowledge and experience of the clinician was a key theme in the positive nature of feedback linking to another key theme of improved confidence to manage their condition. These results highlight the value to patients of specialised knowledge amongst health professionals. Remote consultations may provide access to specialist knowledge “out of area” and may be an efficient method of delivering self-management advice References [1]Marzo-Ortega M, et al. COVID-19 in Axial Spondyloarthritis care provision: helping to straighten the long and winding road. Lancet Rheumatology . 2021. Jan 3(1) e11-13 Disclosure of Interests Emily Clarke Speakers bureau: Has previously received speaker fees from Novartis Pharmaceutical UK, Jill Hamilton: None declared, Sally Dickinson: None declared